ONC Chief’s Perspectives On Patient Privacy and Security

Privacy and security are vital components of all major projects that the Office of the National Coordinator for Health IT has under way, says Karen DeSalvo, M.D., the new head of the office.

“We consider privacy and security an important part of the work that we do,” says DeSalvo in an interview with Information Security Media Group. “It’s increasingly complex as we think through care models, mobile health, ehealth, telehealth and the broader issues of big data and how we make certain that people’s health information is first and foremost there to improve their care wherever they are … but, as they desire, is also available [for research] to help advance the health system and population health overall.”

DeSalvo, who took on the job of national coordinator for health IT in January, also notes: “The way we are making decisions at ONC, we’re building in processes that ensure we consider every aspect of the decision,” including critical privacy and security issues.

ONC, a unit of the Department of Health and Human Services, coordinates nationwide efforts to implement electronic health records as well as the secure electronic exchange of health information. It takes a lead role in developing guidelines for programs under the HITECH Act, including the EHR incentive program, called the “meaningful use” program. That entails setting security and privacy requirements.

Top Priorities

Among ONC’s priorities for this year is work involving protections for big data, which is also a key initiative of the White House, she says. “There’s been a series of conversations with the private sector about what are the challenges and opportunities, and we’ve been participating in those,” DeSalvo says. A government report is being prepared on “some of the next steps that the federal government thinks we should undertake,” she says.

Big data plays an important role in conducting meaningful healthcare research, but the information must be adequately protected, DeSalvo says.

“Consumers often say in surveys that if their information can be helpful to advance science, quality and safety of care, and [researchers] protect their privacy and security in the way they define – and they’re not discriminated against – they’re open to ways for [their information] to be part of anonymized data [used for research],” she says.

ONC also must take steps to make certain that patient-generated data shared with clinicians is adequately protected, DeSalvo says.

“Consumers are increasingly taking advantage of technology that’s wearable [and] opportunities to input their own data, whether it’s texting or [on a] website,” she says. Before patient-generated data is shared with clinicians, however, “part of our responsibility is to think through [the risks] and to make sure we are considering ways we can protect security and privacy,” she says.

Before joining ONC, DeSalvo was the New Orleans health commissioner and senior health policy adviser to Mayor Mitch Landrieu. During her tenure as health commissioner, DeSalvo led efforts to modernize the New Orleans healthcare system following Hurricane Katrina. DeSalvo also served as president of the Louisiana Health Care Quality Forum, which leads the state’s HIE and regional extension center projects.